Estheticians

Welcome! Have questions about which Kimberly Parry Organic's skin care products are best for you? You have come to the right place -- just complete the form below and one of our staff estheticians will respond with an email outlining the perfect mix of skin care products for you. Let's get glowing --

First Name:

Last Name:

Email:

Zip Code:

The following questions are used only to assess your skin and to help us select the best products to recommend. We do not use this information for anything else or share it with anyone. Your secret's safe with us.

Age:

Select the one that best describes your skin:

Skin type:

Skin Concerns:

Aging (fine lines, wrinkles) Hyperpigmentation Rosacea/Redness Sensitive, reactive skin Dry, flaky patches Frequent breakouts Occasional breakouts Undereye puffiness Underye circles Eczema Dehydration Dull complexion

Tell us a bit about your daily skin routine:

I cleanse:

AM PM

I exfoliate:

I exfoliate with:

Clarisonic or similar brush Washcloth At home scrub or peel Professional chemical peel Retinols

I moisturize:

AM PM I don't, I have oily skin

Do you regularly use any of the following?

Mask Eye Serum Anti-aging serum Sunscreen Retinols Topical acne products

Are you pregnant or nursing?

No Yes

Allergies - If you have allergies, please describe:

Anything else you'd like to tell us that would be important about your skin or what you are needing assistance with?

Thank you so much for taking the time to complete this information; one of our estheticians will email you with a suggested skin care regimen and a special offer just for you.

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